Provider Demographics
NPI:1780852012
Name:LEONARD, MARY KAY (LMT)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:KAY
Last Name:LEONARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:KAY
Other - Last Name:CORLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7111 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-2380
Mailing Address - Country:US
Mailing Address - Phone:440-842-6052
Mailing Address - Fax:
Practice Address - Street 1:7111 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2380
Practice Address - Country:US
Practice Address - Phone:440-842-6052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist